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patients with established coronary artery disease ( see section 5.1 - Pharmacodynamic properties ) who are stable on concomitant therapy and have no heart failure to reduce the risk of non-fatal myocardial infarction or cardiac arrest
in patients with a history of previous hypersensitivity to the active ingredient perindopril, ACE- inhibitors or any of the excipient ingredients present in Perindopril
during pregnancy and for lactating women
in patients with bilateral or unilateral renal artery stenosis ( see section 4.4 - Special warnings and precautions for use )
in patients with a history of hereditary and/or idiopathic angioedema or angioedema associated with previous ACE-inhibitor treatment ( see section 4.4 - Special warnings and precautions for use)
in patients receiving extracorporeal treatments leading to contact of blood with negatively charged surfaces such as dialysis or haemofiltration with certain high-flux membranes (e.g. polyacrylonitrile membranes such as "AN69") and low density lipoprotein apheresis with dextran sulfate due to increased risk of severe anaphylactoid reactions following treatment with ACE inhibitors. This combination should therefore be avoided, either by use of alternative antihypertensive medicines or alternative membranes (e.g. cuprophane or polysulfone (PSF)) ( see section 4.4 - Special warnings and precautions for use and section 4.5 - Interactions with other medicines and other forms of interactions )
§05
Mechanism & pharmacology
“Perindopril (prodrug), following hydrolysis to perindoprilat, inhibits angiotensin converting enzyme (ACE) both in vitro and in vivo. It is thought that ACE inhibitors reduce blood pressure by inhibiting the enzyme which catalyses the conversion of angiotensin I to angiotensin II.”
Angioedema of face, extremities, lips, mucous membranes, tongue, glottis and / or larynx
Myocardial infarction possibly secondary to excessive hypotension in high-risk patients
Stroke - possibly secondary to excessive hypotension in high-risk patients
Hepatitis, either cytolytic or cholestatic
Curated subset. The full adverse-effect list is in the TGA Product Information; click any citation above to open it.
combined use with aliskiren-containing products in patients with diabetes or renal impairment (GFR < 60 mL/min/1.73 m²) ( see section 4.4 - Special warnings and precautions for use and section 4.5 - Interactions with other medicines and other forms of interactions )
combined use with sacubitril/valsartan fixed dose combinations- Perindopril must not be initiated earlier than 36 hours after the last dose of sacubitril/valsartan ( see section 4.4 - Special warnings and precautions for use and section 4.5 - Interactions with other medicines and other forms of interactions ).